Revsbech P, Anderson G, Diurnal Variation In Peak Expiratory Flow Rate Among Grain Elevator Workers, Br J Ind Med, 1989;46:566-569,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Diurnal variation (DV) in peak expiratory flow rate (PEFR) was studied among 132 workers who accomplished 3 daily PEFR measurements for 3 weeks. DV was calculated as difference between highest and lowest PEFR as percentage of the mean PEFR on each day. Median for the whole group was 5.9%. DV was higher among smokers and workers with work-related pulmonary symptoms. Analysis of variance showed that only age and smoking had a significant effect on DV. 12 workers had abnormally high DV, of whom 7 showed no signs of obstructive respiratory disease by spirometry. If only a single spirometric test had been performed the tentative diagnosis of bronchial asthma could have been missed in these 7 workers.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

** 3 Acceptable peak flow series can be obtained in around two thirds of those in whom a diagnosis of occupational asthma is being considered.

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